In a 59-39 vote that took place just after 8:30 p.m., the Senate passed the Restoring American Financial Stability Act of 2010. Olympia Snowe, Susan Collins, Chuck Grassley, and Scott Brown all crossed the aisle to vote for it. Maria Cantwell voted against it. Arlen Specter and Robert Byrd did not vote. Next up? Conference committee. BUM-bum-bum.

Meanwhile, job figures took a serious wrong turn, wiping out many gains to date. And Paul Krugman warns that Japan-style stagnation may be in America's future.

Happy Friday! And welcome to Wonkbook.

Top Stories

Harry Reid partnered with Barney Frank to get the final votes, reports Brady Dennis: "Leaders successfully courted GOP Sens. Olympia J. Snowe and Susan Collins, both of Maine, in part by including in the final bill provisions that each wanted. Sen. Charles E. Grassley (R-Iowa) also backed the bill. Equally critical was the last-minute push to win over Scott Brown (R), the Senate's newest member. Brown's vote was secured partly through the help of Frank, his Massachusetts colleague. In an interview, Frank said Brown called him Wednesday evening as Frank was working out on the elliptical machine in the House gym. Brown wanted assurances that Frank would fight in conference to preserve provisions in the House bill that protect large and solvent Massachusetts institutions, such as State Street and Fidelity, from "unnecessary intrusion" by government regulators. Over the next 24 hours, Frank sent Senate leaders two letters stating his position, and Brown indicated that "on that basis, he could vote for cloture," Frank said."

All eyes turn towards conference committee, reports Annie Lowrey. "The conference committee is comprised of senior members of the committees that worked on the bills. In this case, that means the House Financial Services Committee, the Senate Banking Committee and the Senate Agriculture Committee — expect to see Rep. Barney Frank (D-Mass.), Rep. Spencer Bachus (R-Ala.), Sen. Richard Shelby (R-Ala.) and Sen. Saxby Chambliss (R-Ga.) as well as Dodd, Lincoln and others. The committee will prepare a “conference report,” splitting the difference between the House and Senate bills; the House and Senate approve the report and then, once signed by President Barack Obama, the bill becomes law. Frank, the head of the House Financial Services Committee, says he expects that done by July 4."

Jobless claims are shooting up, reports Sarah Murray: "New claims for jobless benefits soared last week, a worrisome sign for the slowly recovering labor market. Separately, an index of leading economic indicators fell in April, pulled down by a sharp decline in building permits. The number of workers who filed new claims for unemployment insurance climbed by 25,000 to a seasonally adjusted 471,000 for the week ended May 15, the Labor Department said Thursday. 'We are left with the uncomfortable possibility that the trend in claims has not only stopped falling, but may be turning higher,' Ian Shepherdson, a High Frequency Economics Ltd. economist, said in a note to clients."

Krugman warns that the US could have a Japan-style lost decade: "This isn’t really surprising: you expect inflation to fall in the face of mass unemployment and excess capacity. But it is nonetheless really bad news. Low inflation, or worse yet deflation, tends to perpetuate an economic slump, because it encourages people to hoard cash rather than spend, which keeps the economy depressed, which leads to more deflation. That vicious circle isn’t hypothetical: just ask the Japanese, who entered a deflationary trap in the 1990s and, despite occasional episodes of growth, still can’t get out. And it could happen here."

"So what we should really be asking right now isn’t whether we’re about to turn into Greece. We should, instead, be asking what we’re doing to avoid turning Japanese. And the answer is, nothing."

Table of Contents: Merkley-Levin won't get a vote (and other FinReg news); BP's attempts to limit oil damage may be backfiring (and other energy news); Google is trying to use blogs to undermine an antitrust investigation (and other economic news); and higher taxes for hedge fund managers may be forthcoming (and other domestic policy news).

FinReg

The Merkley-Levin proprietary trading amendment, along with the Brownback auto dealer amendment, won't get a vote, reports Brady Dennis: "Late Thursday, a deal emerged that helped pave the way for the final vote on the financial overhaul -- which passed 59-39. Under the agreement, there would be no vote on Brownback's amendment, and hence no vote on the Merkley-Levin provision, either. But the Senate would plan to hold a procedural vote Monday to instruct members of the House-Senate conference to consider exempting auto dealers when hammering out the difference between the two bills. However, there would be no such suggestion on Levin-Merkley. The two Democrats marched to the Senate press gallery late Thursday to accuse Republicans of pulling the amendment at the expense of auto dealers to protect big banks."

"Levin said that if Republicans indeed withdrew Brownback's auto amendment in order to kill the proprietary trading provision, 'that would be an extraordinary, powerful statement about the power of Wall Street.' Added Merkley: 'This is not what the American public deserves. They deserve a vote on this issue . . . those who want to vote against it don't want to have a recorded vote against it.'"

Obama is planning on campaigning in financial reform in the midterms, reports Michael Shear: "The campaign to make that case began even before the Senate passed the bill Thursday night. In a Rose Garden statement, Obama sought to make the connection between the financial legislation and the lives of everyday Americans and businesses. 'Wall Street reform will bring greater security to folks on Main Street -- to families who are looking to buy their first car or their first home; to taxpayers, who shouldn't have to pay for somebody else's irresponsibility,' Obama said in a brief statement after the legislation cleared a key hurdle."

FinReg would protect regulatory inspector generals from presidential pressure, reports Ed O'Keefe: "The five -- at the Federal Reserve Board of Governors, the Commodity Futures Trading Commission, the National Credit Union Administration, the Securities and Exchange Commission, and the Pension Benefit Guaranty Corp. -- campaigned for the Senate amendment, arguing their work would be compromised by partisan politics and the election cycle if the president could hire and fire them. Congressional Republicans have said they are especially concerned for SEC Inspector General H. David Kotz, who is investigating the agency's decision to file fraud charges against Goldman Sachs at their request. The Senate's 75 to 21 vote to make the five IGs accountable to an agency's commissioners instead of just the agency chief puts it at odds with the House financial reform bill." The House bill elevates the five to presidential appointments.

Regulators should classify credit default swaps are a form of insurance, writes Floyd Norris: "Credit-default swaps are, in reality, insurance. The buyer of the insurance gets paid if the subject of the swap cannot meet its obligations. The seller of the swap gets a continuing payment from the buyer until the insurance expires. Sort of like an insurance premium, you might say. But the people who dreamed up credit-default swaps did not like the word insurance. It smacked of regulation and of reserves that insurance companies must set aside in case there were claims. So they called the new thing a swap. In the antiregulatory atmosphere of the times, they got away with it."

The SEC is investigating whether investors broke legal obligations on the May 6 crash, reports Edward Wyatt: "The enforcement division of the Securities and Exchange Commission is investigating whether market makers and brokerage firms fulfilled their legal obligations to provide liquidity in the markets by buying and selling stock during the sharp market drop of May 6, the chairwoman of the agency said Thursday. The S.E.C. is also looking into whether market makers and brokers executed investors’ trades correctly."

One tenth of American banks are "problem banks" according to the FDIC, reports Michael Crittenden: "A total of 775 banks, or one-tenth of all U.S. banks, were on the Federal Deposit Insurance Corp.'s list of 'problem' institutions in the first quarter, as bad loans in the commercial real-estate market weighed on bank balance sheets. Poor loan performance in other sectors also continued to hurt banks, with the total number of loans at least three months past due climbing for the 16th consecutive quarter, FDIC officials said in a briefing on Thursday. 'The banking system still has many problems to work through, and we cannot ignore the possibility of more financial market volatility,' FDIC Chairman Sheila Bair said."

Republicans are cowards for not unanimously filibustering FinReg, writes Peter Wallison: "Why was the GOP unable to stand united and filibuster the bill before it reached the Senate floor? For the least meritorious of reasons, it seems: unwillingness to go to the voters this November without having done 'something' to punish Wall Street and the banks. This is true even though Senate Republicans know perfectly well that government housing policies were the principal cause of the financial crisis and the bill does nothing to address this issue, and that the losses of Fannie Mae and Freddie Mac—whose chief sponsor over many years was the same Barney Frank—will cost the taxpayers far more than TARP. Republicans also know that the last time they ran off without thinking they saddled American corporations with the huge, unwarranted costs of the Sarbanes-Oxley Act." Guess Grassley, Collins, Brown, and Snowe will be getting some fun mail?

Big banks will lose from FinReg, writes Noam Scheiber: "And yet, perhaps unwittingly, the upshot of financial reform will have been to make it costlier to be a big bank relative to being a small or medium-sized bank—which is to say, it has effectively taxed bigness. That’s because the legislation imposes a handful of new mandates and regulations—like oversight by a soon-to-be-established consumer financial protection agency, as well as limits on fees for debit-card transactions—from which small and medium-sized banks are exempt."

"Other reforms—such as a bill Congress passed last year to limit hidden credit-card fees and make statements more transparent, and new restrictions on trading derivatives—would disproportionately dent profits at megabanks. These banks tend to have far bigger credit card operations, and are the only real derivatives brokers to speak of. The big banks typically complain that these efforts will drive them out of this or that line of business, or at least curtail their activity significantly. But in a world in which we worry about megabanks doing too much rather than too little, that’s not necessarily a bad thing. If only there were a bit more of it."

The EPA is ordering BP to use a cleaner dispersant to clean up the oil spill, report Campbell Robertson and Elisabeth Rosenthal: "Local and state officials here voiced desperation on Thursday as their fears became far more tangible, with oil from the BP spill showing up on shore as tar balls, sheens and gooey slicks. In Washington, the Environmental Protection Agency said it had told the oil company to immediately select a less toxic dispersant than the one it is now using to break up crude oil gushing from a ruined well in the Gulf of Mexico. Once the agency has signed off on a different product, it said, the company would then have 72 hours to start using it."

Oil has made it to the Louisiana coast, report Angel Gonzalez and Jeffrey Ball: "'We knew it was coming,' said PJ Hahn, Plaquemines Parish's Coastal Zone Manager. Mr. Hahn saw the crude first-hand on Wednesday in the sensitive Pass-a-Loutre Wildlife Management Area. 'It was just thick, gooey oil in pools all up against the marsh," he said. The marshes, which teem with wildlife, help keep erosion at bay, and if they're damaged by the crude, officials fear that even more of Louisiana's rapidly disappearing coastline would melt away into the Gulf. 'We haven't seen the worst of it,' said Billy Nungesser, president of Plaquemines Parish, the area where the Mississippi empties into the gulf and the bulk of the beached oil has been found."

The White House is negotiating new emissions reductions with the auto industry, reports Josh Mitchell: "The announcement would come almost a year to the day after the Obama administration said it would order auto makers to increase the fuel economy of automobiles sold in the U.S. to 35.5 miles per gallon by 2016, four years faster than current federal law requires.…The White House and industry representatives plan to announce that they will start work on ensuring that standards are in place for 2017 and beyond, said several industry officials, who declined to be named because an announcement hasn't been made."

Scientists are attacking the government response to the oil spill, reports Justin Gillis: "The scientists assert that the National Oceanic and Atmospheric Administration and other agencies have been slow to investigate the magnitude of the spill and the damage it is causing in the deep ocean. They are especially concerned about getting a better handle on problems that may be occurring from large plumes of oil droplets that appear to be spreading beneath the ocean surface. The scientists point out that in the month since the Deepwater Horizon oil rig exploded, the government has failed to make public a single test result on water from the deep ocean. And the scientists say the administration has been too reluctant to demand an accurate analysis of how many gallons of oil are flowing into the sea from the gushing oil well."

Government scientists resigned after trying to stop plans for arctic drilling, reports William Yardley: "A proposal to drill for oil in the Arctic Ocean as early as this summer received initial permits from the Minerals Management Service office in Alaska at the same time federal auditors were questioning the office about its environmental review process. The approvals also came after many of the agency’s most experienced scientists had left, frustrated that their concerns over environmental threats from drilling had been ignored."

Greens should be fighting for good climate outcomes, not ideal mechanisms, writes David Roberts: "The left is constantly mired in inscrutable technocratic debates over mechanisms -- cap-and-trade or carbon tax? auction or free allocation? Clean Air Act or not? -- when it's the goals of the legislation that ought to be at issue. How much carbon pollution do we want to reduce? What kind of power do we want to use, and how much? How many jobs do we want? These are questions with which the public can meaningfully engage."

Toyota is investing big in electric cars, reports Jim Motavalli: "Tesla Motors and Toyota Motor announced on Thursday that Tesla had bought the recently closed Nummi assembly plant in Fremont, Calif., where it intends to make its Model S luxury electric sedan and other future models. Also, Toyota said it had agreed to buy $50 million of Tesla common stock upon the completion of its planned initial public offering. The companies also said they intended to cooperate on the development of 'electric vehicles, parts and production system and engineering support.' Production of the Model S will begin in 2012 at Nummi, the plant that had been a joint venture of Toyota and General Motors. Tesla said production of the Model S would occupy only a small part of the factory."

Google is battling an antitrust investigation by blogging about it, reports Thomas Catan: "Many of the technology-savvy people contacted by Federal Trade Commission staff investigating Google Inc.'s $750 million deal to buy mobile advertising company AdMob Inc. have written online about the conversations. Some of their blog posts discuss the kinds of questions the FTC is asking, the apparent attitudes of agency investigators and their level of familiarity with online advertising. 'There is no way the FTC knows enough to support a decision to block the deal,' wrote a blogger from Wertago, a mobile nightlife application. The post was entitled 'Ignorance and Hubris at the FTC.'"

"Though there is no written rule against disclosing the details of such investigations, FTC staffers typically tell potential witnesses that such inquiries are nonpublic.…Google and AdMob certainly hope the online chatter will help their deal get approved. Both Google and AdMob Chief Executive Omar Hamoui have encouraged some mobile-software companies to blog about their experiences with the FTC and say why they support the deal, according to people familiar with the matter. Google points to the blogs as evidence that those who best know the sector support the acquisition."

Officials in the US and Europe are considering intervening in currency markets to save the Euro, report Bob Davis, Brian Blackstone, and Dinny McMahon: "Officials in the U.S. and Europe concerned about the euro's decline are cautiously talking about a policy tool they haven't used in a decade: intervening in currency markets."

The economy is on the agenda for Clinton and Geithner's China trip, reports Mark Landler: "On the agenda: trying to balance the economic relationship between China and the United States, breaking down trade and investment barriers, and moving China toward a market-driven exchange rate. But despite rising political pressure at home, administration officials said the United States did not plan to make a public show of pressing Beijing to loosen its policy of pegging its currency to the dollar. And it does not expect China to take any action on the currency until at least next month, because Beijing is loath to appear to yield to outside pressure."

The head of the European Central Bank is facing increased criticism, report Jack Ewing and Steve Erlanger: "For the first time in a long life of technocratic excellence, the president of the European Central Bank, Jean-Claude Trichet, finds both his judgment and his credibility in question. The crisis of the euro and the panic of the markets have pushed Mr. Trichet, 67, who has run the bank since 2003, into bending the rules, compromising his principles and appearing to give way to political pressure from panicked national leaders. In doing so, he may have saved the euro but lost part of his reputation for probity. 'The E.C.B. lost its virginity,' said Marko Skreb, a former governor of the central bank in Croatia. 'The last couple of days have clearly indicated that we live in a new world.'”

Europe's real sorry case is Germany, writes Steve Pearlstein: "At one end is a powerful and highly efficient industrial export engine that generates a large trade surplus with the rest of the world, including most other countries in the eurozone. Instead of spending this new export wealth on a higher standard of living, however, parsimonious Germans prefer to save it, handing it over to thinly capitalized German banks that have proved equally efficient in destroying said wealth by investing it in risky securities issued, not coincidentally, by trading partners that need the capital to finance their trade deficits with Germany. To prevent the collapse of those banks, German taxpayers are dragooned into using what remains of their hard-earned savings either to bail out their hapless banks or their profligate trading partners."

Greece could use some privatization, writes Allan Meltzer: "Much of Greece's industry and commerce, including much of the tourist industry, is owned by the state. It should be sold with the proceeds used to reduce public debt. That would make the remainder of the debt more sustainable and transfer workers to the private sector where competitive pressures for lower wages and increased productivity would more closely align employment costs and reality. If the socialist government returned more of the economy to the private sector, Greece would have a better chance of economic recovery. Much of the Greek economy not owned by the state is "underground," in the so-called informal sector, where wages and incomes adjust quickly to the market. Greece also should offer an amnesty for unpaid back taxes to those who join the legal sector."

The Fed doesn't see a need to provide more help to Europe, report Michael Derby and Luca di Leo: "The Federal Reserve saw no new demand for a special lending program it set up to relieve pressures in short-term bank loan markets in Europe in the week ended Wednesday. It counted $9.205 billion loaned by the European Central Bank to euro-zone banks via a 'swap' program in which the Fed sends dollars to foreign central banks and they lend them to local firms in need of dollar funding. That amount was unchanged from the previous week. The Fed reopened this emergency dollar lending program as concerns about debt-laden euro-zone nations came to a head last week, unsettling short-term lending markets and sparking a move out of risky assets and a rally in the U.S. Treasury market. The introduction of the Fed program came in conjunction with the unveiling of a European Union and International Monetary Fund €750 billion, or $1 trillion, bailout package for euro-zone nations and as the ECB started buying bonds of some member states."

Geithner is meeting with British and German officials about the European crisis next week, reports Ian Talley: "U.S. Treasury Secretary Timothy Geithner will travel next week to the U.K. and Germany to meet with top economic officials and discuss ways to resolve the current economic crisis in Europe, the Treasury said Thursday. Mr. Geithner will first meet Wednesday with U.K. Chancellor of the Exchequer George Osborne in London, on his way back from the U.S.-China Strategic and Economic Dialogue. He will then fly to Frankfurt Wednesday evening to meet with European Central Bank President Jean-Claude Trichet. The following day, he will meet with German Finance Minister Wolfgang Schaeuble in Berlin before traveling back the Washington."

Democrats are looking to raise taxes on hedge fund managers, reports Martin Vaughan: "Tax rates on private-equity and hedge-fund manager pay would rise to roughly 35%, from their current levels of 15%, under legislation unveiled Thursday by House and Senate Democrats. The proposal from Senate Finance Committee Chairman Max Baucus (D., Mont.) and House Ways and Means Chairman Sander Levin (D., Mich.) represents a compromise between House lawmakers who wanted to tax all fund managers' pay the same as wages and numerous Senate Democrats who wanted to preserve lower taxes for at least some of that income. The fund manager tax increase would help pay for a broad package of legislation that extends jobless benefits and renews expired tax breaks."

Bipartisanship shouldn't end careers, writes Ron Wyden: "I still think I had a pretty good idea for health reform -- despite its rejection by significant Democratic and Republican leaders -- but so did Bob Bennett. I was on the Senate floor three years ago when Bob walked across the center aisle to tell me he was willing to work with me on health reform. I had been meeting with him and other Senate colleagues for many weeks to talk about the Healthy Americans Act and what I believed was a historic opportunity for Democrats and Republicans to work together on an important issue. Ideologically, Bob and I couldn't be more different. He's pro-life. I'm pro-choice. He voted for the Iraq war; I didn't. If Bob has ever seen a tax break he didn't like, I am unaware of it. But one thing Bob and I have in common is our fundamental belief that we were elected to do more than just get reelected, that once elections are over we have a duty to try to govern even if it means working with people with whom we don't always agree." Aww…

Reading scores are down in urban school districts, reports Stephanie Banchero: "Students in large U.S. cities are struggling to improve their reading ability, especially at middle-school levels, according to results from a national reading test released Thursday. Only Atlanta and Los Angeles, two of the 11 urban centers that took the reading exam, showed growth in eighth-grade reading from 2007 and 2009. They also were the only two to show growth since 2002. Four districts notched gains at the fourth-grade level since 2007, while five showed progress since 2002. The test scores are part of the urban National Assessment of Educational Progress, or NAEP. Known as the 'nation's report card,' the exam has been given in urban districts biennially."

Small businesses aren't benefiting from a provision in health care reform targeted at them, reports Ricardo Alonso-Zaldivar: "When the administration unveiled the small business tax credit earlier this week, officials touted its 'broad eligibility' for companies with fewer than 25 workers and average annual wages under $50,000 that provide health coverage. Hoffman's workers earn an average of $35,000 a year, which makes it all the more difficult to understand why his company didn't qualify. Lost in the fine print: The credit drops off sharply once a company gets above 10 workers and $25,000 average annual wages. It's an example of how the early provisions of the health care law can create winners and losers among groups lawmakers intended to help — people with health problems, families with young adult children and small businesses. Because of the law's complexity, not everyone in a broadly similar situation will benefit."

Massey Energy faced withering criticism in the Senate on mine safety, reports Kris Maher: "The testimony, particularly Mr. Blankenship's, incensed 92-year-old Sen. Robert Byrd (D., W.Va.)., who noted that there were 10 safety violations a day at Massey mines. 'This is a clear record of blatant disregard for the welfare and safety of Massey miners. Shame!' As for MSHA, Mr. Byrd told Mr. Main that the agency 'still has much to explain.' He pressed Mr. Main on why his agency waited until after the accident to launch an inspection blitz of 57 other mines that had a pattern of safety violations. The Senate Appropriations Committee, with oversight over spending on mine safety agencies, scheduled the hearing to discuss steps that need to be taken to make the nation's mines safer. Such steps include raising funding for MSHA and reducing the backlog of cases before the federal Mine Safety and Health Review Commission that rules on safety violations contested by operators."

Congressional Democrats are moving forward on a "doc fix", reports Jennifer Haberkorn: "During the reform debate, physician lobbies including the American Medical Association, wanted a full overhaul of the formula, called the sustainable growth rate, but agreed to back reform after Democrats said they would address it later. The proposal released Thursday as part of a broad jobs and tax bill would increase payments to doctors by almost $60 billion over three years to offset the planned cut. A final draft of the legislation was expected to be released later Thursday and the House was set to vote on it next week."

Health care reform threatens employer-based health insurance, writes John Goodman: "Take a hotel with maids, waitresses, busboys and custodians all earning $10 or $15 an hour. These employees can qualify for completely free Medicaid coverage or highly subsidized insurance in the exchange. So the ideal arrangement is for the hotel to fire the lower-paid employees—simply cutting their plans is not an option since federal law requires nondiscrimination in offering health benefits—and contract for their labor from firms that employ them but pay fines instead of providing health insurance. The hotel could then provide health insurance for all the remaining, higher-paid employees. Ultimately, we could see a complete restructuring of American industry, with firms dissolving and emerging based on government subsidies."

great article by Alonso-Zaldivar on the HC tax credit. While the administration keeps selling and spinning, the truth is that many will not qualify for the credit especially if you live in the sections of the country like the Northeast and CA where your income levels don't allow you to benefit but the costs are higher because of mandates for coverage. Add this together with the fact that everyone will believe that their dependents will be covered after they graduate or by September 23rd (and many will not) and you'll get a lot of disgruntled voters come November who will feel like they've been shafted.

As far as Goodman's article its 100% wrong. Those employers like the example he uses weren't offering benefits now as it is. Yes they'll dump on the exchange but i would think (uh hope) that the government's expectation was that those employers would be doing that anyway. Its not as if your local motel was offering healthcare now. Like anything else they will find a way around the law.

Ezra, you only mentioned Cantwell, and Feingold is the other Dem Senator who voted against this weak Bankster/Wall St. reform bill. The info on the wheeling & dealing to get MA Repub Brown to go along was new to me, tho, and very discouraging. No wonder we despise most of our senators and representatives! Ever wonder what became of Obama's promise of campaign finance reform? I'm still waiting, but dread it also, seeing health care and finance reform get so perverted. Despite how it makes my jaws tight, thnx for this great info. I'll check it regularly from now on.

The Ricardo Alonso-Zaldivar report cited above, which busts the myth that the small business tax credit of the PPACA actually helps small businesses, concludes with the statement that "To get the most out of the new federal credit, Hoffman said he'd have to CUT HIS WORK FORCE TO 10 EMPLOYEES AND SLASH THEIR WAGES. 'That seems like a strange outcome, given we've got 10 percent unemployment,' he said."

Note that "The Treasury Department, which administers the new credit, did not dispute the calculations."

So, even the administration is agreed that some so-called benefits of the PPACA are indeed not benefits at all. What does this say about the skill of the scholarly economists who reviewed the PPACA prior to enactment? Shouldn't we as citizens be a bit more skeptical of their future evaluations of Obama Administration policy proposals? What makes the evaluations of the PPACA any more or less misleading than evaluations of Cap-and-Trade, for example?

"All eyes turn towards conference committee, reports Annie Lowrey. "The conference committee is comprised of senior members of the committees that worked on the bills. In ..."

Well Good Morning to you, lover!

The Ezra doubles down, AGAIN linking to his lady lover Annie Lowrey. (Listen kiddo, if journalistic ethics have gone out the window at The Post with this new journalism ... at least disclose, disclose, disclose every time you link to this woman that she indeed is your lover?

Even Megan McCardle is classy enought to link to Peter Suderman on an as-needed basis, and she pretty much discloses everytime their personal relationship.

You know, so that in years to come when your errors roll out on the carpet -- LOL you supported the Iraq War dude??? wth? --- we can all be clear how you might have been misled by analyzing the issues.

You know, continually linking to your g/f and all... (There's a reason nepotisma and full disclosure rules exist. You're not immune. Says a lot about the Wa Po standards though. Shame she's the only person out there providing such info, and you have no choice but to risk the appearance.)

Ezra: I find it interesting that you failed to put your progressives spin on Caldron's speech before Congress. Since the majority of America is supportive of the AZ law, you missed an opportunity to wave the flag yesterday. What's the matter? I guess you must support Felipe's position....and are against policing our borders. I expected you to spin, spin, spin on this topic!

DOCTORS SHOULDN'T BE ABLE TO DOUBLE DIP AND HAVE LABS IN THEIR PRACTICE THAT THEY OWN.

Maybe you should ask your doctor what he makes per year. Look below for some startling figures.

http://mdsalaries.blogspot.com/

I've seen doctors try to do that and they had better have a loyal RICH following otherwise they'll soon realize the mistake they're making.

So which is it Lomillalor are you going to whine that you're losing your doctor or that costs are too high for you to afford without subsidies that buffer you from the true cost of care. You do realize you can't have it both ways don't you?

Border violence is going DOWN before the AZ law was even voted on. See link below.

The recession is causing a reduction in illegal immigration. This all proves that if you enforce existing laws to heavily penalize Americans who hire people illegally, and if you expand the number off work visas, this problem would be easily solved.

Canada strictly enforces its hiring laws and has no illegal immigration problem even though northern American states on its border do.

Lastly, many Americans may indeed support the AZ law, but they are either misinformed or they are racists. In any case, the members of the business wing of the Republican party and many business owners across the country do not support the AZ law.

http://abcnews.go.com/print?id=10690707

P.S. Most southerners supported slavery at one time too, but that doesn't mean they were right.

wait? expand the number of work visas when we have 10% unemployment already?

I'll grant you we need to penalize employers who hire illegals but I can't believe you had the audacity to use the words illegal immigration and easily solved in the same sentence. That's ludicrous. Many know that even a biometric card won't "easily solve" anything.

So wait 64% of Americans are racists or misinformed? REALLY?? Many Dems (37%) support the law as well. No comment for them? Maybe they just support enforcement of EXISTING laws.

I simply reported a story. You can decide for yourself whether it poses some issue conflict in your tiny brain.

P.S. My DR has the most reasonable charges for services I've ever experience. A blood test or visit in his office costs me around $85.00 whereas the same test as labcorp would be over $600.00 His office is not located in a wealthy area and his clientele seem to be all blue-collar workers or blue-hairs. If he is getting rich, it is because he is popular because of his low costs and high-quality care and as a result he is attracting lots of appreciative patients.

before you tell me I have a "tiny brain" I'd suggest you learn proper grammar. Its "I've ever experienced, not experience".

But I digress.

Just please understand that you have no contemplation of the system. While I'll readily admit I don't know you're doctor at all, Lab Corp does not get paid $600 when they bill an insurance company. They get paid a greatly reduced fee. Are you really going to try to convince me that your local doctor charges (and is paid less by an insurer) than a large corporation like LabCorp that has economies of scale that your doctor could never hope for in his wildest dreams?

That's like arguing prices at your local store are less than Walmart. Sorry, not possible. Maybe you like it better and that's fine but your argument on pricing is completely wrong.

And IF his patients are blue collar can they really afford (especially nowadays) to pay full retail price as opposed to going to a doctor that participates with their insurer? If I were you I'd be throwing your doctor a going out of business party.

Last time I checked, Dems were Americans. So go back and read my statement carefully. It's in english after all.

And yes, the problem is easily solved by expanding work visas as needed and strictly penalizing Americans who hire illegal immigrants. A properly functioning work visa program would include mechanisms to adjust the number of annual visas based on current job situations. We currently restrict work visas because otherwise we would have no pool of low income workers. People on visas cost more to employ.

the point was that you made sure to originally blast pro-business Republicans but didn't mention Dems at all. I'm sure that was just an oversight that I'm glad you corrected. Again with the "easily solved". If it was SOOO EASY then I'm thinking the administration (as bright as Obama is and that's no slap at him, he is bright) would have done so already.

Your poll you cite is apples and oranges. One is an opinion (immigration reform) and the other is misinformation spread by a previous administration (you know that evil Bush guy).

First, I am self-pay. I have no clue what the insurance costs are regarding my comments.

Blood tests can include a large number of different tests. The more tests, the more expensive the total bill will be. This is true even at my DR office.

But I get routine tests every four months at my DR, and the one's I get cost $85 at my DR office (my DR draws the blood and sends out for certain tests). Last time I tried to go to labcorp several years ago they charged me over $600 for those same tests. That's why the DR allowed me to get the tests in his office. Shortly after I started that he decided to make more money by doing blood draws. But now he is finding that the insurance companies are uncooperative and no longer wants to deal with them.

So if you are self pay why do you personally care if he takes insurance or not? Why even bring it up, or is that just to take a swipe at insurance companies because its the "progressive" thing to do?

Again I ask you what does your doctor make per year? Did you even bother to go to the link I gave that showed most make 200k-$600k on average?

So wait you're comparing what your doctor charges you for just drawing the blood (if i'm reading you correctly its $85 just to draw it) and then sends it out for tests (THAT COST MONEY TOO!) as compared to doing it all at LabCorp which does the draw and the test all in one spot?

It'd be nice if you AGAIN compared equivalent number of services to equivalent number of services. Oh forget it. I've wasted enough of my day on this.

My earlier link to the Saddam poll proves they are often misinformed on the most important issue of the day.

Large number of Americans believed only last year that the Chinese were drilling for oil in US waters (Senator (R) Martinez had a press conference to correct that) and that gulf oil companies used the best available and safest technology.

MOst Americans today think we have a war going on at our southern border that is getting worse. That's all you hear on the news. Yet ABC news did a study (see my earlier link) that says that is hogwash.

Most Americans today believe Obama has raised their taxes though the opposite is true.

Also, you never hear that the recession is reversing the flow of illegals in recent years or that the border patrol has drastically increased in size or that violence is under control on our southern border or that if you build a 10' wall all you need is an 11' ladder to get over it.

@Lom: "The recession is causing a reduction in illegal immigration. This all proves that if you enforce existing laws to heavily penalize Americans who hire people illegally, and if you expand the number off work visas, this problem would be easily solved."

While I have no problem with the Arizona law (the actual one, not the straw-man one that opponents keep going on about), I gotta say Lom has a point there. Punish Americans who hire illegals, and otherwise dry up the illegal job market in America, and the illegal immigration problem is greatly reduced. Although that would, unfortunately, require verifying the immigration status of the illegal employees before enforcing the law.

Regarding doctors that stop taking insurance to only take Medicare/Medicaid--wow. Insurance companies are all about not paying claims, no doubt about that, but I've heard mostly horror stories about getting Medicare and state Medicaid programs to pay for stuff. Your doctor must have had remarkably good luck with Medicare.

"or that if you build a 10' wall all you need is an 11' ladder to get over it."

Which alone provides a compelling limitation. That being said, all you need in your 10' super fence are capacitance alarms that indicate to patrols when and where a ladder is placed against the fence. After a dozen-dozen border crosses are interdicted attempting to cross, the word will get out that it's not a good way to go. Liberalize immigration rules, speed up the process, or fast track Mexican (rather than, say, Saudi Arabian) visas, illegal immigration would be greatly reduced.

It doesn't take much for a criminal to clip the phone wires on the outside of the house (thus defeating 95% of monitoring systems), yet statistics indicate houses with alarm systems still get burgled less. Doesn't take much to shoot a dog, but houses with guard dogs also get burgled less.

Doesn't take anything more than a good pair of legs (and strong arms) to jump a standard 6' fence. Heck, I don't really have either (and I'm overweight, besides) and I've still done it. But people still put fences around their yard. Doesn't take any more than a pair of bolt cutters to cut a padlock, but I still have one on the shed I keep my lawn equipment in. And so on. All it takes to defeat a bullet proof vest is to aim for the groin or the head. But people in risky professions still wear them.

The "all it takes is a taller ladder" argument is inherently fallacious, and self-evidently inconsistent with any number of behaviors in all walks of life. I imagine many of the folks who decry the idea of a border fence still locks their cars. Even though all it takes . . .

"DOCTORS SHOULDN'T BE ABLE TO DOUBLE DIP AND HAVE LABS IN THEIR PRACTICE THAT THEY OWN."

I'm not taking a side on the grudge match that is underway here, I am just asking a question. Why would an insurer care whether the lab is independent or in-house? As long as they reimburse at the same rate, who cares if the blood is sent out to a separate facility, or analyzed in the doctor's office?

"That's like arguing prices at your local store are less than Walmart."

Sometimes that is possible. There is a musical instrument store in my town that offers small items like guitar strings, at their dealer cost, much cheaper than even the giant online retailers. They see it as providing a service to the customers and make that trade-off to service a loyal clientele. It does not boggle my imagination that a few (certainly not most) physicians might take a similar view about routine lab work.

Again, I'm not taking any side, just honestly wondering what's the systemic harm in a doctor's office having the capability to do its own lab work?

No matter how many alarms and bells you add to a fence, and no matter how tall it gets, unless you hire substantially more numbers of guards to put on that fence, people will find a way to get over, around or thru it IF WE CONTINUE TO LURE THEM OVER HERE with jobs that pay better than over there.

At least two million people escaped the berlin wall, and we will never have a wall that secure.

Also, I don't have the figures in front of me, but my recollection is that a significant percentage of illegals here today arrived here legally and overstayed their visas and remain here.

I do support a fence project simply because it would create lots of jobs, but other than that, there are simpler and more effective means to deal with illegal immigration. I have already hinted at that solution in earlier comments but of course there are many aspects to it, including the need for national ID cards.

Even though Canada has a nice std of living too, Canada has only a hundred thousand or so illegal immigrants, instead of our 12 million, because among other things they strictly penalize offending employers.

Our business wings of our parties don't want to end the status quo because then the legal workers would be paid more and have expensive health care, etc.. That is why we intentionally limit the number of work visas and why the GOP won't consider expanding that program to cover ALL NEEDED FOREIGN LABORERS. And yes, the Dems even seek a path to citizenship for some immigrants and the GOP balks at that, and that clearly indicates the GOP is the roadblock to even an increased visa program.

really KOS? If i wanted to refute it I could put up a Lewin article but what sense would that be?? They're both horribly slanted. They hold their hopes out on recision which has proven to be a small sliver of denials of coverage?? Any reason why Aetna's 6.4% and everyone else is some ridiciulous figure? Oh forget it. If you're going to rely on that you're way past gone.

Patrick,

doctors that have labs in house are just like surgery centers that do work in house. They work off of UCR if they don't participate. (Lomillalor ask your doctor if his labs ever participated with an insurer). By using UCR figures doctors can inflate what they receive. I once had a client who went to a maternal fetal specialist for two months while she was inpatient and this doctor saw her for 10 minutes each day to check her meds she was on and charged her insurance $2500 per day (worked out of Morristown Memorial Hospital in Northern NJ). The insurance allowed up to the 90% percentile of UCR ($600 per day). The balance he wrote off. The reason I finally got out of the billing dept is because it inflates UCR levels so they get more money in the future when UCR is adjusted.

Its all a sick game to some of them. Now its a small percentage of docs that abuse the system but it happens.

I think you just like to hear yourself talk. You can't seem to focus or stay on topic. People like me and Patrick relate their real-world anecdotal stories and you come back with gibberish that it can't be true or must be illegal.

I apologize as this is what I do and have done for the last 15 years. If you were "in the medical industry" you would understand it. If not then i guess it sounds like gibberish.

If you need me to explain what UCR is (its usual, customary and reasonable) by definition it is what 90% of doctors within a certain area charge. If doctors charge way outside the norm, knowing they won't ever receive that figure they can and may be inflating those figures to up the average.

If you can't understand that . . . well then i'm just wasting my time.

And exactly how wasn't that on topic? Patrick asked me a question and I answered it. Exactly what was off-topic about it other than the fact that you didn't understand it since I used "industry-speak"?

either way you seem to want so badly to believe you're right or those that believe what you believe are right you'll grasp onto anything (even quoting polticial blogs which you said you hate) to try to convince yourself of something. Here's a tip. If you have to fight against something to try to believe its true, its usually not.

Your inference that my DR must be doing something illegal because he has a lab dept is a joke.

I simply related his story about his insurance woes and you went bonkers and even claimed that labcorp's business model is like Walmart's.

I also showed you how wrong you are to claim that the American people are never misinformed, yet you can admit no fault in your silly defensive arguments even when the stark reality stares you in the face.

P.S. If there was something wrong with the analysis by KOS, please illuminate us. In the meantime I will ignore that silly AMA claim about medicare. The AMA is no more credible than KOS (indeed, it is interesting how I can't find a third-party corroboration of that medicare claim).

I have to confess that I still don't understand why there is anything wrong about lab work within a doctor's office. But my inablity to follow visionbrkr's explanation is not very different from the fact that when I try to read my homeowner's and auto insurance policies there are many sentences I don't understand.

I can figure out the warranty on my car, but parts of my auto insurance policy seem to be written to be incomprehensible to the consumer.

I looked at the DailyKos piece. I admit again that I have zero insurance expertise, but I agree that some of the points made there in opposition to the AMA data seem to make sense.

I know that personal anecdotes are not dispositive, but nevertheless I will simply observe the following -

My father died from cancer. There were many different providers and complex bills. Medicare was the primary payer.

During the same period of time, my wife had surgery for a benign tumor. The number of billings was significant, but much less numerous and complex than for my father. The primary payer was our employer-provided insurer, which at that time was Blue Cross.

Our private insurer's handling of the claims on the more simple illness my wife endured was a mess. They denied charges that should have been paid. They paid the surgeon twice for the same surgery, only noticing the mistake when I pointed it out.

By contrast, Medicare caught every single billing error by the providers, and we had zero headaches wih my father's much more extensive and complex bills. Dealing with Blue Cross was infuriating, dealing with Medicare was unnecessary-their system was flawless, in our complex real-life experience..

So when I hear that there is data that Medicare rejects more claims, I wonder whether that means they reject more valid claims, or whether there are actually better at weeding out invalid provider charges.

I don't claim to know any answers, I just have questions, but I am a little bit skeptical about the data from AMA, if for no other reason than raw numbers of claims denied seems a bit vague and in need of further differentiation.

medicare's patients tend to be older Americans who tend to need lots of care. Go figure! I am thinking care givers tend to make lots of claims for them, needed or not, because of defensive medicine, and other reasons, such as profit motives, valid or not, and it is left to the insurers to make sense of the credible claims.

medicare probably deals with more claims than all other insurers combined, as such, it makes sense that it is possible they deny more claims than all combined, not because those claims are valid, but because taking care of the elderly and sick is complicated and care givers tend to use every trick in the book to take care of them or to profit from them.

Here's a link that refutes that KOS piece which btw as mentioned is referencing a study done by the California Nurses Association which is a huge proponent of single payer which obviously makes them biased. And if the AMA was biased FOR insurers then why would they have been for reform? Just to clue you in doctors HATE insurance companies. They pay them less than they think they're worth, make them work more and sometimes question what work they do (based upon strict industry based guidelines).

http://www.independent.org/blog/?p=4459

Also the 2009 report showed Medicare got better but so did insurers.

Patrick,

to me there's nothing wrong with it IF its done within the same cost structures. Its when it costs much more that I have an issue. Lab work is less of an issue than say o/p surgeries because the costs are much higher.

As far as your personal experiences I will gladly tell you that insurers are not perfect. They deny claims they shouldn't and are sometimes a real PITA to deal with. Although many times people act as if its intentional which really annoys me. If you knew some of the claims people that process claims as i do they're regular working people but they're human, they make mistakes (just like the Medicare people). And honestly many of both claims payers (Medicare and private insurance are auto-ajudicated, ie processed by computer). Those systems are very good but not fullproof.

Whenever a client asks me "which insurance company pays claims the best?" I tell them that all the ones we deal with are good (which they are, remember I'm in practically a guaranteed issue state) but if you lined up 10 doctors and asked them if they had to pick one insurer who pays their claims the easiest, quickest, best you'd probably get 10 different answers. Its all just personal preference. that's one huge reason why I would have loved Wyden-Bennett. If all plans in the US were on an exchange and employers could pay for their employees' costs on an exchange it could allow employees and employers the best of both worlds and I think (and agree with President Obama) that you can't go straight to single payer that you could go straight to Wyden-Bennett.

That link does not debunk KOS. SO I am still waiting for a detailed and thorough link to a study.

It also does not show that the medicare analysis carefully investigated private insurers or held them to the same standard as medicare.

I would bet the private insurer stats are taken for granted and were reported BY the private insurers, all of whom are notorious for hiding the actual numbers of recissions and denials they have done. To this day no one knows how many recissions and denials they have done, and recent testimony to congress has not cleared it up.

I seriously doubt medicare engages in willful recissions or denies applicants because they are already sick. I am sure they make mistakes too, something they have in common with private insurers, but as to predatory practices--I doubt it.

BTW, if you can't stand the heat, stay out of the kitchen. You like to try to humiliate or impugn people or knee-jerk act contrarian to them whether or not they make a point. If you don't like the way people react to your nonsense, then don't provoke them.

First, you can't find evidence to prove how many recissions they have done because they keep it secret and refuse to provide data to congress. So right there off the bat your mission will fail. If it weren't for the fact we have people testifying that they have been victims, we'd never know.

Second, we all know how many insurers are trying to raise premiums by like 39% last year, so I would not call that improvement.

Third, I tried getting private insurance last year but was denied because of pre-existing conditions. That's not improvement either. It is obvious this is a widespread problem, and not just mine.

"...to me there's nothing wrong with it IF its done within the same cost structures. Its when it costs much more that I have an issue."

That's really the answer to my question. Thanks.

"As far as your personal experiences I will gladly tell you that insurers are not perfect. They deny claims they shouldn't and are sometimes a real PITA to deal with."

In the decade that has passed since my personal anecdote about my father's death, I have found private insurers to be somewhat better at claims processing, but still pretty awful, and I frequently have to call them out for having paid on billing errors (for which I get hit with the 20%).

So, to me, the stats on denial of claims are kind of meaningless, unless you also know which claims are valid. I applaud any system for catching claims that are not valid, before a consumer has to straigten things out. As a consumer, I hate having to play the part of the umpire that corrects obvious errors in the billing between providers and insurers.

"to me there's nothing wrong with it IF its done within the same cost structures."

I am quite sure that if a DR has a lab dept, it is most probably in line with fed/local laws. For you to automatically assume otherwise means you are shooting from the hip to hear yourself talk.

Posted by: Lomillialor | May 22, 2010 8:40 AM | Report abuse

Where did I say the doctor did anything illegal? Laws and cost structures are two totally different things.

I also now get your issue. You were denied coverage by an insurance company due to pre-existing conditions so IMO you're biased against them and I get that. I'd probably be biased too but I would hope that I would also look at irrefutable evidence as proof too. You still haven't proven why the AMA study is wrong and or biased. It also was (in my previous link) shown by Politi-fact that the study used by KOS WAS biased yet you chose to ignore it. So be it. If you can't get past your anger towards insurers for denying you coverage there's not much I can do.

Patrick,

thanks. Here's another issue that I hadn't thought about either that give me issues with doctor owned labs, x-ray facilities etc. The self-referring to those facilities are greatly increased by the attached studies due to the profit motives. This isn't the AMA but academics that have done this so hopefully Lomillalor will not totally dismiss this out of hand and Ezra has linked to these types of studies before.

I notice you mention you don't accept the AMA report that insurers improved in 2009 but you mention nothing of how they said Medicare got better too. Just forget to mention that or is it more of your anti-insurer sentiment from being denied access to coverage?

"I notice you mention you don't accept the AMA report that insurers improved in 2009 but you mention nothing of how they said Medicare got better too. Just forget to mention that or is it more of your anti-insurer sentiment from being denied access to coverage?"

The AMA is not agenda-free. Their goal is to make profits for their members.

I am willing to be educated on medicare issues of this nature so long as someone provides sufficient data AND/OR credible links to cite credible studies that were conducted fairly and with sufficient data from both the private insurers and medicare.

But as I earlier said, private insurers have refused to share the needed data with congress or anyone else, so it quite impossible at this time to compare medicare with private insurers in any way but generally.

That said, simply provide me with the data or proof that shows medicare routinely engages in recissions (or similar predatory practices) and I will start raising my eyebrows.

"I also now get your issue. You were denied coverage by an insurance company due to pre-existing conditions so IMO you're biased against them"

I have been in favor of universal health since at least the early nineties. I had employer coverage up until 2003. So obviously you are making an assumption.

Posted by: Lomillialor | May 22, 2010 12:35 PM | Report abuse

I obviously have no way to prove this so I'll take you word for it. Kind of like how you 'used to be' a Republican. I take your word for that although I'm skeptical of it. People don't usually go from being Republicans to progressives from what I've seen.

I am a 12 year USAF veteran who voted for Reagan twice, BushSr once, and who then woke up to the reality of just how nihilistic and deceiving GOP politicians are (since BushSr). I joined the service when 17 in 1973 and spent many years since then overseas away from domestic politics.

I think my political awakening started when I watched the Thomas Clarence hearings in 1991 and solidified when I saw how far BushSr would go in 92 to win an election.

Even before that, I have long felt the B1 bomber was a waste of money and started wondering when the peace dividend would kick in so we could cut defense spending and extend health coverage to all Americans.

I have long believed the nation would be best served if we provided universal health and education to all who wanted it.

My mother worked all her life on minimum wage and died of cancer in 1994 and the only care she received was because of gvmt provided benefits. I have long been grateful to Democrats for her wretched payraises and health care and, in her last year or so in life, Social Security payments.

Many in my family are devout bigots I've long had to tolerate though I love them. I have spent lots of time in the deep south and understand southern attitudes and motivations.

I am a person of conscious and integrity and I am here to learn about complex issues, and I don't do things like comment on other's grammar when my own is suspect too.

Yesterday I admitted to you I was wrong about something, thus, proof when I am wrong I admit it.

And despite all this, you challenge my basic honesty after you rattle off assumptions instead of sticking to facts and logic, and though I have effectively countered several of your wild claims and ramblings on this thread all I get is an assertion of my dishonesty.

I don't need to lie to debate people like you. I will either admit when I am wrong or counter with facts and logic and proof, which I have easily done so.

It is amazing you think that I must be lying that I used to be a Republican. What a tiny thought that is that people don't change parties or paradigms.

Actually, I never was right-wing.

I've even noticed you taking potshots at me in threads where I haven't even commented, and you wonder why I get animated when I'm talking to you.

I don't care what you think. All you do is rattle off assumptions and level charges of dishonesty when you're wrong.

You actually owe me an apology, but I know I'll never get it. Que Sera Sera